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|Ethambutol HCl Ethamolin

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Ethambutol HCl

Pronouncation: (eth-AM-byoo-tahl HIGH-droe-KLOR-ide)
Class: Antituberculosis agent

Trade Names:
Myambutol
- Tablets 100 mg
- Tablets 400 mg

Mechanism of Action

Pharmacology

Inhibits synthesis of 1 or more metabolites, causing impairment of cell metabolism, arrest of multiplication, and cell death.

Pharmacokinetics

Absorption

The T _max is reached in 2 to 4 hr.

Metabolism

Primarily metabolized in the liver to a dicarboxylic acid derivative.

Elimination

Approximately 50% excreted unchanged in the urine; 8% to 15% excreted as metabolites; 20% to 22% excreted unchanged in the feces.

Indications and Usage

Treatment of pulmonary tuberculosis in combination with 1 or more other antituberculous agents.

Contraindications

Patients with known optic neuritis; hypersensitivity to any component of the product.

Dosage and Administration

Adults and Children (13 yr and older)

PO In patients not previously treated with antituberculous therapy, administer 15 mg/kg as a single dose every 24 hr. In patients who have received previous antituberculous treatment, administer 25 mg/kg as a single dose every 24 hr.

General Advice

Administer without regard to meals. Administer with food if GI upset occurs.

Storage/Stability

Store tablets at controlled room temperature (59° to 86°F).

Drug Interactions

Aluminum salts (eg, aluminum hydroxide)

The absorption of ethambutol may be delayed or reduced; separate the administration times by several hours.

Laboratory Test Interactions

None well documented.

Adverse Reactions

CNS

Malaise; headache; dizziness; mental confusion; disorientation; possible hallucinations; numbness and tingling of extremities.

EENT

Decreased visual acuity.

GI

Anorexia; nausea; vomiting; GI upset; abdominal pain.

Hematologic

Eosinophilia.

Hepatic

Transient liver function impairment.

Metabolic

Elevated serum uric acid; precipitation of acute gout.

Respiratory

Pulmonary infiltrates.

Miscellaneous

Hypersensitivity (including anaphylactoid reactions; dermatitis; pruritus); fever; joint pain.

Precautions

Monitor

Mycobacterial studies

Assess mycobacterial studies and susceptibility tests before and periodically throughout therapy to detect possible resistance.

Pregnancy

Category B .

Children

Safety and efficacy not established in children under 13 yr.

Renal Function

Reduced dosage is necessary.

Visual effects

Unilateral or bilateral changes in visual acuity may occur. Evaluation of changes is more difficult in patients with visual defects such as cataracts, diabetic retinopathy, or optic neuritis. Ensure that ophthalmoscopy, finger perimetry, and color discrimination are evaluated prior to and periodically during therapy.

Patient Information

Explain name, dose, action, and potential side effects of drug.
Review dosing schedule and prescribed length of therapy with patient.
Emphasize to patient that treatment will be lengthy and that the entire course of treatment must be completed to avoid relapse or development of resistance.
Advise patient to take each dose without regard to meals, but to take with food if GI upset occurs.
Instruct patient to immediately report the following to health care provider: change in vision, visual abnormalities.
Advise women to contact health care provider if pregnant, planning to become pregnant, or breastfeeding.
Instruct patient to not take any prescription or OTC medications or dietary supplements unless advised by health care provider.
Advise patient that follow-up visits and lab tests will be required to monitor therapy and to keep appointments.

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